Cardiac asthma may occur in chronic cardiac patients when the underlying disease becomes decompensated, or as a manifestation of an acute cardiac condition, such as an extensive myocardial infarction that causes functional impairment of a large left ventricular mass. Such a patient will have bronchial hyper responsiveness [1] that is partially responsible for some elements of the clinical picture.

Cardiac asthma manifests as acute dyspnea and tachypnea that may progress to orthopnea and is accompanied by wheezing and dry cough. The patient may appear pale initially, but as the symptoms progress may become cyanotic. The episode may be more or less severe. The mildest form of cardiac asthma is represented by orthopnea. It is immediately relieved once the patient sits up straight in bed or on a chair for a few minutes (usually less than 10). Paroxysmal nocturnal dyspnea, the second stage in terms of severity, lasts for at least 30 minutes, even if the same position described above is assumed. It occurs during the night and symptoms wake the patient up. They consist of severe dyspnea, increased work of breathing, and gasping, causing anxiety. Acute pulmonary edema has the most dramatic presentation and the most severe origin: fulminant left ventricular failure. The patient appears very ill and experiences severe dyspnea and tachypnea. Hypoxia may cause restlessness or obnubilation, while poor peripheral perfusion may manifest as cold, sweaty extremities. The patient uses accessory respiratory muscles and experiences cough that is initially dry and subsequently becomes productive. The sputum is frothy and may contain blood.

During the acute episode, the patient may experience chest pain, usually caused by myocardial ischemia. Tachycardia diminishes the duration of the diastole and subsequently coronary filling time, also causing chest pain [2]. Palpitations can signify sinus tachycardia, atrial or ventricular arrhythmia.

Outside the acute dyspnea episode, the patient complains about other symptoms caused by chronic heart failure, such as fatigability, peripheral edema, oliguria, and nocturia.

• Hypoxemia

  Mechanisms of hypoxemia. Lung India. 2017;34(1):47-60. doi:10.4103/0970-2113.197116 Jorge S, Becquemin MH, Delerme S, et al. Cardiac asthma in elderly patients: incidence, clinical presentation and outcome. [verywellhealth.com]

  When the symptoms are severe enough it can lead to hypoxemia or too little oxygen in the blood. Cardiac asthma can ultimately require ventilatory support such as intubation or admission into an intensive care unit. [asthma.about.com]

  Thus, we used a different cut off point to select ARF from that which is usually considered, with mild hypoxemia (70 mmHg or less). [dx.doi.org]

• Collapse

  But then the blood pressure gradually decreases, which is a signal of accession collapse. Listening to the heart can not be as noisy breathing and wheezing abundance do not give to do it. [ladyen.netlify.com]

  Loss of elasticity leads to the collapse of the bronchioles, obstructing airflow out of the alveoli. Air becomes "trapped" in the alveoli. [medicinenet.com]

• Dyspnea

  After symptoms have subsided, pulmonary function testing can be performed to exclude respiratory dyspnea causes. [symptoma.com]

  The term cardiac asthma is much more suitable for this condition than is paroxysmal dyspnea alone, which is far less descriptive and which may include other conditions, such as Cheyne-Stokes respiration. [jama.jamanetwork.com]

  dyspnea that occurs in association with heart disease, such as left ventricular failure. [medicine.academic.ru]

• Sputum

  Cardiac asthma is a paroxysmal acute dyspnea generally occurring at night but sometimes following exertion, lasting from minutes to hours and accompanied by a sense of suffocation, by wheezing and often by cough with frothy sputum, which may or may not [jama.jamanetwork.com]

  The sputum is frothy and may contain blood. During the acute episode, the patient may experience chest pain, usually caused by myocardial ischemia. [symptoma.com]

• Rales

  Arrive ER and he was opened up enough that the doc could hear some fine rales in the bases. [emtlife.com]

  In the distance hear the dry, wheezing Auscultation Wet fine basal rales, mainly in the lower lung Dry rales, mainly on the exhale. Very long exhale [medicalency.com]

  Deep sounding rales in the chest. Baryta Mur Is indicated in old asthmatic patients with high blood, pressure. Loss of memory and mental weakness. Suffocating cough with no power to expectorate. Worse by every change of weather. [knowhomeopathy.com]

  […] reduced, but may be normal or elevated.Often asthma goes into the initial stage of pulmonary edema, as evidenced by the blue face (especially in the nasolabial triangle), cold clammy sweat, acting on the body of the patient, the appearance of wet bubbling rale [diets-doctor.com]

  When treatment of pure cardiac asthma is effective, the wheezing usually resolves quickly -- at which time the rales indicative of heart failure may then be heard. Corticosteroids require several hours until they attain peak effect. [medscape.com]

• Labored Breathing

  Wikipedia cardiac asthma — noun : asthma due to heart disease (as heart failure) that occurs in paroxysms usually at night and is characterized by difficult wheezing respiration, pallor, and anxiety called also paroxysmal dyspnea * * * cardiac asthma, labored [medicine.academic.ru]

  Clinical examination of a cardiac asthma patient reveals an anxious, diaphoretic, pale or cyanotic individual, with labored breathing, tachycardia or gallop rhythm, cold extremities and elevated jugular venous pressure. [symptoma.com]

• Basilar Rales

  Obviously with a longer transport time i would hopefully had been able to hear the fine basilar rales after the treatment, but for the future i want a stronger tool set to seperate these Corky uggg..... missed one tonight. 0130 called to male short of [emtlife.com]

  rales may be audible on auscultation. [amboss.com]

• Cyanosis

  If you experience breathing problems such as wheezing and/or coughing along with cyanosis (bluish tinged skin) then call and ambulance or head to the nearest emergency room as soon as possible. [bellaonline.com]

  PX - CAOX4, skin pale warm dry, Heent unremarkable with oral mucosa moist and no circumoral cyanosis, JVD not noted, chest bilat equal rise/fall with diminished lung sounds with expiratory wheezing and base line O2 of 89 on 2 L/min via his home O2. [emtlife.com]

  The skin is usually pale and moist with perspiration, but in a severe attack there may be cyanosis of the lips and nailbeds. [medical-dictionary.thefreedictionary.com]

  The symptoms can become progressively worse, including:1 Cyanosis (blue-tinged skin, lips or fingernails) Cold sweats Coughing up blood-tinged mucus Diagnosing cardiac asthma is not as easy as it might seem. [asthma.net]

• Tachycardia

  Tachycardia diminishes the duration of the diastole and subsequently coronary filling time, also causing chest pain. Palpitations can signify sinus tachycardia, atrial or ventricular arrhythmia. [symptoma.com]

  30 minutes. 2019-02-25 01:16:26 Goran 80 Year Old Female: “Rapid Heart Rate” It is regularly irregular rythm.It seems like Mobitz type 1 - Wenkebach ,secondary to sinus tachycardia.It is visible P wave in V1 lead.We should find primary cause of sinus tachycardia [ems12lead.com]

  One found that it may improve pulmonary function, hemodynamic stability, and fluid clearance from the alveolar space, but also noted side effects including hypokalemia, tachycardia, and dysrhythmias. [canadiem.org]

  Typical signs: tachycardia, tachypnoea, pulmonary rales, pleural effusion, raised jugular venous pressure (JVP), peripheral oedema, hepatomegaly. [patient.info]

• Hypotension

  In patients with high blood pressure it dropped by 27% vs. the initial level; in patients with hypotension the change was only minimal. [ncbi.nlm.nih.gov]

  Fluid management: Aggressive diuresis (e.g., IV furosemide) to reduce volume overload Vasodilators: (e.g., IV nitroglycerine) can be considered as adjunct treatment in patients without hypotension. [amboss.com]

  16.67% Metoprolol Succinate: 2 people, 16.67% Furosemide: 2 people, 16.67% Eprex: 1 person, 8.33% Duragesic-100: 1 person, 8.33% Top symptoms for these people *: Acute Kidney Failure: 3 people, 25.00% Face Oedema (swelling of face): 3 people, 25.00% Hypotension [ehealthme.com]

  When symptoms of alveolar membrane, which began hypotension, mixed asthma is introduced in / prednisone or hydrocortisone. When the foam is applied electric pump or spend inhalation defoamers (10% solution antifomsilana). [ladyen.netlify.com]

  Nitroglycerin dosing beyond 200 mcg/min is not recommended, and the patient requiring it should be considered a nonresponder. 25,26,28 Some side effects associated with nitroglycerin use are hypotension, headache, and abdominal pain. [uspharmacist.com]

• Stroke

  Impaired blood flow to the brain can lead to a stroke and cause an elevation in cardiac enzymes. [livestrong.com]

  This means that many Canadians suffer from stroke and other types of heart diseases. [firstaidcalgary.ca]

  Migraines, Epileptic Fits, Cataract Zoom-Osteomalacia-Shock Zoom- Rheumatoid Arthritis Zoom- Smoking Effects, Blood Vessel Constriction, Arteries Hardening, Cancer Zoom- Symptoms of Serious Illnesses Zoom-Tuberculosis-Rheumatic Fever Zoom-Hypertension Zoom- Stroke-Smoking [assam.gov.in]

  He added that the World Health Organisation has shown that there is a strong link between air pollution exposure and respiratory illnesses, heart diseases as well as stroke. [thehindu.com]

Clinical examination of a cardiac asthma patient reveals an anxious, diaphoretic, pale or cyanotic individual, with labored breathing, tachycardia or gallop rhythm, cold extremities and elevated jugular venous pressure. Chronic heart patients may also have pleural effusion, making lung auscultation more difficult. When feasible, auscultation reveals the presence of basal crepitations. Wheezing can be heard in acute pulmonary edema cases. The Kussmaul sign (paradoxical rise in jugular venous pressure on inspiration) and hepatojugular reflux are present and the diastolic blood pressure may be slightly increased. The liver may be enlarged and painful.

Pulmonary and cardiac dyspnea can be rapidly differentiated by measuring the brain natriuretic peptide, which rises in heart failure patients [3]. After symptoms have subsided, pulmonary function testing can be performed to exclude respiratory dyspnea causes [4].

The electrocardiogram is often abnormal in heart failure patients, showing signs of acute or chronic myocardial ischemia, acute tachyarrhythmia or bradyarrhythmia or at least left atrial enlargement [5]. Systolic and diastolic functions are best evaluated by echocardiography, which is important because reduction of either of these parameters can be associated with cardiac dyspnea. This method also identifies the cause of the heart failure, such as valvular diseases or ischemia [6] [7]. Transesophageal echocardiography, if tolerated, is especially useful because it allows direct measurement of pulmonary capillary wedge pressures [8]. Genetic testing is indicated in cases of hypertrophic and dilated cardiomyopathy [9], arrhythmogenic right ventricular cardiomyopathy and left ventricular noncompaction.

• Hypercapnia

  Missing values were observed for natriuretic peptides values ( n = 139 (27%)), estimated creatinine clearance ( n = 30 (6%)), and hypercapnia and acidosis ( n = 24 (5%)). Thus, the final logistic model was performed in 347 (68%) patients. [dx.doi.org]

  Our study suggests that emergency physicians should focus on past diagnosis of COPD in patients with CHF and cardiac asthma, especially in those presenting with hypercapnia. [doi.org]

The distinction is important because treatments for asthma and heart failure are different. Treatments for heart failure can help improve your symptoms for both the heart failure and the cardiac asthma. [drugs.com]

Treatment of cardiac asthma infusions and broths Treatment of cardiac asthma with use of mix of herbs Mummy, goat milk and fruit in treatment of cardiac asthma Treatment of cardiac asthma infusions and broths In traditional medicine there is a number [herbalthera.com]

Although there is no cure for cardiac asthma, research to better understand heart failure and design better treatments is ongoing. Talk to your doctor about the most current treatment options. [resourcerepository.org]

Both groups had a similar prognosis (Fig. 1 ). Indeed, one could assume that cardiac asthma had a better prognosis because auscultation revealed fewer crackles, which could suggest less alveolar edema [ 23 ]. [dx.doi.org]

The prognosis for people with heart failure and preserved LV ejection fraction is a little better than the prognosis for people with heart failure and reduced ejection fraction. Generally, the lower the ejection fraction, the poorer the prognosis. [patient.info]

In a study pays special attention to signs of underlying pathology that will help determine the etiology of dyspnea. [ladyen.netlify.com]

However, the etiology of cardiac asthma is different from true asthma that occurs due to inflammation and narrowing of air passages. In cardiac asthma the problem is related with heart. [tandurust.com]

Etiology ADHF typically occurs in patients who have a history of CHF or other cardiac conditions in which an acute cause precipitates the deterioration of cardiac function. [amboss.com]

Paschke spent 4 years as a Heisenberg Professor in a molecular laboratory in the Institute of Interdisciplinary Research at the Universite Libre in Brussels, Belgium working on the molecular etiology of hot thyroid nodules and the mechanism of activation [departmentofmedicine.com]

It is important to correctly identify the etiology of the patient’s symptoms because treatment differs for these disorders, and incorrect treatment of cardiac asthma may exacerbate the condition. [uspharmacist.com]

Epidemiology Since cardiac asthma and bronchial asthma have differing etiologies, it is pertinent to discuss epidemiological differences because the disease processes dictate the populations most affected. [uspharmacist.com]

References:[2][3] Epidemiological data refers to the US, unless otherwise specified. [amboss.com]

Epidemiologic and genetic aspects of spina bifida and other neural tube defects. Dev Disabil Res Rev. 2010;16(1):6-15. doi: 10.1002/ddrr.93. Review. Bassuk AG, Kibar Z. Genetic basis of neural tube defects. [ghr.nlm.nih.gov]

Epidemiology [ 1, 3 ] Currently around 920,000 people in the UK have a diagnosis of heart failure. Prevalence in developed countries is approximately 1-2% of the adult population, increasing to 10% or more in those over 70 years of age. [patient.info]

Cardiac asthma produces the same symptoms, but the pathophysiology producing these symptoms is not well described. [ncbi.nlm.nih.gov]

The pathophysiology of the two is different with BA having an immune mediated airway narrowing, and CA having a transudative pulmonary oedema. [differencebetween.com]

To the Editor: The role of bronchial hyperresponsiveness in the pathophysiology of dyspnea in congestive heart failure has been a subject of considerable interest 1 3. [dx.doi.org]

The cardiopulmonary interaction forms the basis for the pathophysiology of cardiac asthma —a state in which disease or failure of the former manifests in pathologic findings and symptoms of the latter, the majority of which are reversible with correction [journals.lww.com]

Asthma Prevention: Prevent for Asthma Attacks and Asthma Prevention With Naturist Treatment Skin Asthma: Causes, Signs, Symptoms,Prevent, Treatment and Home Remedies Seasonal Asthma Symptoms, Causes, Treatment and Prevent Asthma Prevention: Prevent for [tipdisease.com]

Its use can prevent heart attacks and heal its after effects. Dead cells have no substitute, but it is possible to prevent another attack, because the adjacent cells are damaged by the increased load and lack of energy. [mumio7.com]

Prevents the spread of illness and infectious disease. Protects against environmental hazards. Encourages healthy behaviors to prevent chronic disease. Plans and responds to health emergencies. [phila.gov]

Corticosteroids are used as they are known to constrict blood vessels and prevent release of cytokines. They are used only when the patient does not respond to other medications. [tandurust.com]

In children For children, treatment focuses on determining the extent of symptoms and disabilities as they develop and preventing those that can be prevented. [healthline.com]

1. Chua TP, Lalloo UG, Worsdell MY, Kharitonov S, Chung KF, Coats AJ. Airway and cough responsiveness and exhaled nitric oxide in non-smoking patients with stable chronic heart failure. Heart.1996; 76(2):144–149.
2. Peacock WF, Fonarow GC, Ander DS, et al. Society of Chest Pain Centers Recommendations for the evaluation and management of the observation stay acute heart failure patient: a report from the Society of Chest Pain Centers Acute Heart Failure Committee. Crit Pathw Cardiol. 2008;7(2):83-86.
3. Morrison JF, Pearson SB, Dean HG. Parasympathetic nervous system in nocturnal asthma. Br. Med. J. (Clin. Res. Ed.) 1998;296(6634):1427–1429.
4. Dickstein K, Cohen-Solal A, Filippatos G, et al, for the Task Force for the Diagnosis and Treatment of Acute and Chronic Heart Failure 2008 of the European Society of Cardiology. ESC Guidelines for the diagnosis and treatment of acute and chronic heart failure 2008: the Task Force for the Diagnosis and Treatment of Acute and Chronic Heart Failure 2008 of the European Society of Cardiology. Developed in collaboration with the Heart Failure Association of the ESC (HFA) and endorsed by the European Society of Intensive Care Medicine (ESICM). Eur Heart J. 2008;29(19):2388-2442.
5. Lindenfeld J, Albert NM, Boehmer JP, et al, for the Heart Failure Society of America. Executive summary: HFSA 2010 comprehensive heart failure practice guideline. J Card Fail. 2010;16(6):e1-194.
6. Prior D, Coller J. Echocardiography in heart failure - a guide for general practice. Aust Fam Physician. 2010;39(12):904-909.
7. Abraham J, Abraham TP. The role of echocardiography in hemodynamic assessment in heart failure. Heart Fail Clin. 2009;5(2):191-208.
8. Meersch M, Schmidt C, Zarbock A. Echophysiology: the transesophageal echo probe as a noninvasive Swan-Ganz catheter. Curr Opin Anaesthesiol. 2016;29 (1):36-45.
9. Grunig E, Tasman JA, Kucherer H, Franz W, Kubler W, Katus HA. Frequency and phenotypes of familial dilated cardiomyopathy. J Am Coll Cardiol. 1998;31(1):186-194.